infancyepistaxis

Infancy epistaxis refers to nosebleeds that occur in infants, typically in the first year of life. Most bleeds in this age group are anterior, arising from the nasal septum, and are usually short, mild, and self-limited. Serious bleeding is uncommon but may signal an underlying condition, such as a congenital bleeding disorder, if bleeding is heavy or recurrent.

Causes and risk factors include dryness of the nasal mucosa from low humidity or indoor heating, minor nasal trauma from rubbing or finger contact, nasal irritation from infections or allergies, and occasionally foreign bodies. Less commonly, systemic problems or medications that affect clotting can contribute. In many cases, no identifiable cause is found.

Presentation and evaluation involve a brief history and a focused examination. Parents may report sudden blood loss from one or both nostrils, sometimes with mild distress. In the clinic, the clinician assesses airway patency, volume of blood loss, signs of anemia, and potential causes. If there are recurrent or heavy bleeds, or signs of a bleeding disorder (bleeding from other sites, easy bruising), further laboratory evaluation may be indicated.

Management at home emphasizes safety and simple measures. Have the infant sit upright with the head neutral, and apply gentle direct pressure to the soft lower part of the nostrils for 5–10 minutes. Avoid tilting the head back. After bleeding stops, use saline drops and maintain nasal moisture to prevent recurrence. Avoid nose picking and irritants; NSAIDs should be avoided unless advised by a clinician.

When to seek care urgently: if the bleeding does not stop with pressure after 10–15 minutes, if the infant appears lethargic or pale, or if there is frequent or heavy bleeding or signs of anemia. In persistent or recurrent cases, a medical evaluation is warranted to identify underlying causes and consider professional treatment.